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- Alvarsson Jan-Åke, Agüero Oscar, Bretschneider Peter, Brunius Staffan, Gumucio Juan Carlos, Gurt Carl-Johan, Hultkrantz Åke, Isacsson Sven-Erik, Johnsson Mick, Kurkiala Mikael, Liljefors-Persson Bodil, Perruchon Marie & Århem Kaj
(författare)
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Amerikas indiankulturer
- 1997
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Bok (övrigt vetenskapligt/konstnärligt)
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| 3. |
- Brännström, Inger, 1945-
(författare)
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Community participation and social patterning in cardiovascular disease intervention
- 1993
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This study addresses health policy and public health in the field of cardiovascular disease (CVD) on the local level in Sweden. The overall aim is to contribute to the assessment of structural and social conditions within public health by analysing participation processes and outcome patterns in a local health programme. The northern Swedish MONICA study served as a reference area. The research strategy has been to integrate quantitative and qualitative methodologies and, thereby, focus on different aspects of the health programme under study.The mortality rate was excessive in the study area of Norsjö relative to both provincial and national figures over a period of more than 10 years. This finding formed the basis for a tenyear comprehensive and community-based health programme towards the prevention of CVD and diabetes.Even in this seemingly homogeneous area it was found that socio-economic circumstances were associated with the public health. Almost half of the study population had hypercholesterolaemia (;>6.5 mmol/1), 19% of men and 25% of women were smokers and 30% and 29%, respectively, had high blood pressure. Age had a strong impact on all outcome measures. After adjustments for age and social factors it was found that the relative risk of having hypercholesterolaemia dropped significantly in both sexes during the six years of intervention. The probability of being a smoker was significantly reduced only in highly educated groups. No statistically significant change over time could be found for the risk of suffering high blood pressure. In the reference area of northern Sweden there were no changes over time for any of the selected risk factors. The likelihood of self-assessed good health decreased with increasing risk factor load, with the exception of hypercholesterolaemia , in all social strata.The authorities, including the health and medical staff, were the main actors on the mediastage. Men in manual occupations were least affected by the media coverage. The actors and the public as well as the media viewed the health programme as orientated towards individual lifestyles. Community participation was mainly defined by the actors based on the medical and health planning approach. Differences in interpretations, social interests, personal conflicts and ideological constraints among the actors at local level were observed. Some critical attitudes towards the organization and management of the health programme were also noted among the citizens. However, a majority of the public wanted the health programme to continue. The present study underlines the importance of considering age, gender and social differences in the planning and evaluation of CVD preventive programmes.
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- Dychawy-Rosner, Irena, et al.
(författare)
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Caring dynamics as perceived by staff supporting daily occupations for developmentally disabled adults
- 2001
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 1471-6712 .- 0283-9318. ; 15:2, s. 123-132
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Tidskriftsartikel (refereegranskat)abstract
- This study addresses caring staff experiences of hindrances and help in the support of daily occupations among people with developmental disabilities. Data were collected by means of a questionnaire consisting of open-ended questions about the staff perceptions of their work experiences. The respondents (n = 81), corresponding to 94.1% of all care staff employed in a geographically defined care area in southern Sweden, worked in various day activity units supporting the daily occupations of their clients. A constant comparative method of data analysis was used. Staff expressions were classified in two main categories of caring dynamics: an operational level and a managerial level. Four areas were identified at the operational level: encountering realities of practice, attitudes to the clients and work demand, using the potential of knowledge and strategies and applying helping actions to the client. The managerial level included two areas, generalized work strategy and individualized work strategy. It is suggested that to develop the quality of interventions for supporting daily activities among persons with developmental disabilities, efforts should be made to identify caring dynamics as experienced by the caring staff.
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- Eriksson, T, et al.
(författare)
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HIV/AIDS--information and knowledge: a comparative study of Kenyan and Swedish teenagers
- 1997
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Ingår i: Scandinavian Journal of Social Medicine. - 0300-8037. ; 25:2, s. 111-118
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Tidskriftsartikel (refereegranskat)abstract
- Knowledge of hiv/aids, exposure to hiv/aids information and appreciation of given information was studied, by a questionnaire, among 326 Kenyan and 146 Swedish teenage school students in 1994. The aim of the study was to examine differences and similarities in knowledge in the two populations and to examine which sources of information about hiv and aids the respondents had been exposed to and which were most appreciated. The overall knowledge about hiv/aids was high but in specific items the knowledge and awareness of different risk behaviours for contracting hiv/aids differed for the Kenyan and Swedish teenagers. The dissemination of hard factual information about hiv/aids has thus been successful in reaching out although not in stopping the spread of hiv/aids. This calls for new strategies in disease prevention and health promotion. Those strategies should focus much more on lifestyle changes. The health care system, the school and the existing strong civil and voluntary information structures have an important role to play in that work.
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- Fransson, Anette M. C., 1954-, et al.
(författare)
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Gender differences in oral appliance treatment of obstructive sleep apnea
- 2024
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Ingår i: Sleep and Breathing. - : Springer. - 1520-9512 .- 1522-1709. ; 28:4, s. 1723-1730
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Although overall success rates for treating obstructive sleep apnea (OSA) with an oral appliance (OA) are high, they are significantly higher among females. To verify published data, the study's purpose was to evaluate a participant sample after one year of OA use. The primary outcome was treatment response, with responders defined as having an apnea-hypopnea index (AHI) < 10 at follow-up and/or reduced by ≥50% of baseline. Secondary measures were from standardized questionnaires.METHODS: A sample of 314 participants, predominately with moderate-to-severe OSA, were enrolled and instructed to use an OA every night. At baseline and one-year follow-up, polygraphic recordings and questionnaires, including sleepiness (measured using the Epworth sleepiness scale) and quality-of-life (measured using the Functional Outcomes of Sleep Questionnaire), were collected.RESULTS: Among the 314 participants, 192 completed the one-year evaluation: 51 females (27%) and 141 males (73%). Overall, OA treatment resulted in 78% and 77% responders among females and males, respectively. Neither the difference in improvement nor the absolute change in AHI differed significantly based on gender, at any OSA severity level. There were no significant gender differences in sleepiness or quality of life. Treatment-related adverse reactions were more common among females.CONCLUSION: Both females and males with OSA respond well to OA therapy, with nonsignificant gender differences in outcomes. Thus, the hypothesis that females respond better to OA treatment is rejected.
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- Isacsson, G., et al.
(författare)
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Bibloc and Monobloc Oral appliances in the Treatment of Obstructive Sleep apnoea : a Multicenter, Randomized, Blinded, Parallel-Group Trial
- 2017
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Ingår i: Sleep Medicine. - : Elsevier. - 1389-9457 .- 1878-5506. ; 40:Suppl 1, s. E142-E143
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: The clinical benefit of bibloc over monobloc appliances has not been established in randomized trials treating obstructive sleep apnoea (OSA). We hypothesized that the two types of appliances are equally effective in treating moderate to severe OSA. Materials and methods: We performed a blinded, multicenter, randomized, controlled, prospective, parallel-group trial including patients aged 18 years or older who had moderate-to-severe OSA. Patients were randomly assigned to receive either a bibloc or a monobloc appliance with the intention to protrude the mandible 75% of the individual maximal protrusion capacity. At baseline a one-night respiratory polygraphy was done without any respiratory support. The polygraphy was iterated with the appliance in place at a 6-week follow-up. The primary outcome was the absolute change in the apnoea-hypopnea-index (AHI) from baseline to the 6-week follow-up, analysed in the per-protocol population. All patients who received an appliance were included in the safety analysis. This trial is registered with ClinicalTrials.gov, number NCT02148510, and approved by Uppsala Regional Ethical Review Board, Sweden (#2014/021). Results: We recruited patients from three dental specialist clinics in Sweden; enrolment of 302 patients was done between March 2014 and April 2016; 146 randomized to bibloc and 156 to monobloc appliance. Twenty-three patients in the bibloc group and 17 in the monobloc group were withdrawn due to reasons like appliance could not be fitted, lack of compliance, adverse events or non-valid follow-up polygraphy i.e. a per-protocol group of 123 bibloc and 139 monobloc treated patients. The mean change of AHI from baseline to 6 weeks of treatment was -13.8 (95% CI -16.1 to -11.5; p < 0.001) in the bibloc group and -12.5 (95% CI -14.8 to -10.3; p < 0.001) in the monobloc group. The mean difference was not significant between the groups (-1.3 (95% CI -4.5 to 1.9). The most common adverse event in the orofacial region was upper airway infection followed by complains from various parts of the mouth, jaws and teeth. Conclusions: Bibloc and monobloc appliance treatment was equal in their effects in treating OSA as measured by at home polygraphic respiratory measures and the appliances were associated with a similar degree of adverse events. Acknowledgements: Funding from Uppsala-Örebro Regional Research Council and Vastmanland County Council, Sweden.
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| 10. |
- Isacsson, G., et al.
(författare)
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Pain relief following a single-dose intra-articular injection of methylprednisolone in the temporomandibular joint arthralgia-A multicentre randomised controlled trial
- 2019
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Ingår i: J Oral Rehabil. - : Wiley. - 0305-182X .- 1365-2842. ; 46:1, s. 5-13
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Tidskriftsartikel (refereegranskat)abstract
- Background Temporomandibular joint (TMJ) arthralgia is a painful condition assumed to be associated with local inflammation. Objective The objective of the present study was to determine the efficacy for reducing pain of a single-dose intra-articular (IA) injection of methylprednisolone to the TMJ. The hypothesis was that methylprednisolone would effectively reduce TMJ pain. Methods This randomised, double-blind, parallel-group, multicentre, controlled study included visits for enrolment, treatment and 4-week follow-up. The study included patients 18 years and older who had been diagnosed with unilateral TMJ arthralgia. All participants were randomly assigned to receive 1 mL IA injections of methylprednisolone or saline. The primary outcome was change in recorded pain intensity on a visual analogue scale (VAS) at maximum jaw opening, analysed in the per protocol population. Results In total, 54 patients were randomly assigned to single-dose IA injections with methylprednisolone (n = 27) or saline (n = 27). Between baseline and the 4-week follow-up, VAS-rated pain intensity at maximum jaw opening decreased from a mean of 61.0 (95% confidence interval [CI]: 50.1; 70.7) to 33.9 (95% CI: 21.6; 46.2) in the methylprednisolone group and from 59.6 (95% CI: 50.7; 65.9) to 33.9 (95% CI: 23.8; 43.9) in the saline group. The between-group difference was not significant (P = 0.812). Treatment-related adverse events were doubled in the methylprednisolone group. Conclusion Methylprednisolone provided no additional benefit for reducing pain, but caused more harm compared with saline following a single-dose IA injection in patients with TMJ arthralgia.
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